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About Duke University Hospital

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Job Location

Duke Children's Health Center / Valvano Day Hospital

Job Summary

The Duke Children's Health Center Valvano Day Hospital (VDH) Advanced Practice Provider (APP) provides direct patient care services and performs medical acts as an APP under the supervision of the supervising physician to patients 0-21 years. There may be rare occasions for which it would be appropriate for a CPNP to provide care for a patient beyond the age of 21 for a limited/specific period of time. The APP performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, and provides direct patient care services to all patients in the VDH with disease processes including but not limited to oncology, rheumatology, transplant, endocrinology, gastroenterology, and nephrology. The APP will be involved with program coordination. The APP contributes to excellence in patient care, research, teaching, and provides leadership in the organization.

Job Duties and Responsibilities

Clinical Expert

In collaboration with the attending of service and/or residents, fellows, or other advanced practice providers, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.
Provide and coordinate clinical care for service specific patients through established protocols and under the hospitalist supervising physician or back up physician who is either on site or available by pager.
Collaborate with the chief resident, residents, fellows, attending other APP colleagues, nurses, and patient resource managers to formulate treatment plans and monitor patient progress.
Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols.
Assess patients for change in status and institute appropriate interventions. Initiate emergency interventions in an effort to stabilize the patient until physician support arrives.
Postoperative stabilization and management.
Develop patient care pathways, protocols and guidelines for the management of specific problems in conjunction with physicians and other members of the health care team.
Analyze clinical practice patterns so as to provide the best medical care and to increase effectiveness and efficiency.
Communicate verbally and in writing all pertinent patient information to supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.
Document in the patients' medical record all relevant data including but not limited to results of diagnostic tests; laboratory results; patients' condition and response to therapies/interventions; communications with supervising MD.
Utilize prescriptive privileges only for identified patient population.
Prescriptive authority for prescribing, ordering, and or administering drugs; including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.
Role model competence in all nurse practitioner / physician assistant advanced skills.
Give daily handoff to appropriate attending, APP, resident and/or intern at the end of the shift.

Educator:

Assess educational needs of the patient-care staff and provide one-on-one as well as formal education as needed.
Assess educational needs of the patients / families and provide culturally-sensitive patient/family education interventions as indicated. Use non-technical language when educating patients and families. Document all education in patients' medical record.
Implement and evaluate appropriate educational programs for DUHS patient care staff and other healthcare providers as appropriate.
Role model and precept healthcare learners through contractual agreements.

Research Utilization and Investigation:

Utilize current research and evidence-based decision-making in all clinical practice.
Incorporate clinical research findings in the development and implementation of standards of care.
Support IRB approved clinical research/trials though a variety of activities including but not limited to: obtaining consent; ordering diagnostic tests; recording laboratory & diagnostic results; administering therapeutic interventions; and reporting patient outcomes including toxicities or adverse events.
Participate in interdisciplinary quality improvement and/or research activities.
Participate in measuring and documenting outcomes.

Consultant:

Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to pediatric diseases, procedures, interventions, and conditions.
Implement and evaluate appropriate educational programs for referring MDs
Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization.
Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of the Duke University Hospital and Duke University Health System.

Professional Leadership and Development:

Role model advanced practice professionalism through conduct, communication, dress, leadership, ethical decision-making, critical thinking and problem solving skills.
Participate in at least one professional organization.
Demonstrate responsibility for professional practice through active participation in the CAP, and professional organizations. Meet Continuing Education requirements as designated by the NC Medical Board and/or NC Nursing Board. Maintain professional certification.
Enhance the body of knowledge in area of specialization through written publications, oral presentations, posters, continuing education, etc.
Maintain all professional requirements for licensure and certification

Job Eligibility Requirements

Education

NP: Graduate of an accredited MSN or DNP Acute Care Pediatric Nurse Practitioner program.

PA: Graduate of an ARC accredited Master's Degree or Doctoral Degree Physician Assistant program.

Licensure

NP: Current unrestricted RN licensure issued by or recognized by the NCBON with authorization to practice as an NP

PA: Current unrestricted medical license issued by the NCMB with authorization to practice as a PA

Certification

NP: PNP-AC is the only NP certification being considered for this role.

PA: PA-C

Experience

Minimum 1 year of APP experience in a similar practice with management skills to cover the patient population that is seen in the Valvano Day Hospital including but not limited to hematology-oncology, bone marrow transplant, neuro-oncology, rheumatology, endocrinology, gastroenterology, and nephrology.

Physical and mental requirements

Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System.
Able to independently seek out resources and work collaboratively to solve complex problems
Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others.
Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up.
Able to use fine motor skills
Able to record activities, document assessments & interventions; prepare reports and presentations
Able to use computer and learn new software programs
Able to provide leadership in clinical area of expertise and in meeting organizational goals
Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations
Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds
Able to remain focused and organized
Able to work collaboratively with all levels of personnel

Job Hours

Primary hours will be weekdays Monday-Friday 8 hours a day. Schedule may be modified by the clinical or leadership team.

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.